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Lubiprostone for Opioid‐Induced Constipation Does Not Interfere with Opioid Analgesia in Patients with Chronic Noncancer Pain
Author(s) -
Spierings Egilius L. H.,
Brewer Randall P.,
Rauck Richard L.,
LoschBeridon Taryn,
Mareya Shadreck M.
Publication year - 2017
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12444
Subject(s) - lubiprostone , medicine , placebo , opioid , constipation , chronic pain , anesthesia , morphine , physical therapy , chronic constipation , alternative medicine , receptor , pathology
Objective To determine whether lubiprostone 24 μg twice daily ( BID ), administered to relieve opioid‐induced constipation ( OIC ), affects opioid analgesia in patients with chronic noncancer pain. Methods Data were pooled from 3 randomized, double‐blind, placebo‐controlled trials of lubiprostone in adults with chronic noncancer pain receiving stable opioid analgesia and who had documented OIC . In each study, lubiprostone 24 μg BID or placebo was administered for 12 weeks for relief of OIC using a common protocol. The Brief Pain Inventory short form ( BPI ‐ SF ) was administered, and opioid use (expressed as morphine‐equivalent daily dose [ MEDD ]) was recorded at baseline and months 1, 2, and 3. The BPI ‐ SF provided patient scores for pain severity, the worst pain experienced in the past 24 hours, and pain interference with daily life. Results The pooled patient population ( N = 1300) was predominately female (62.5%) and white (82.1%), with a mean age of 50.5 years. The MEDD was 97.5 mg (range, 5 to 3656 mg) in patients receiving placebo and 112.5 mg (range, 4 to 7605 mg) in patients treated with lubiprostone. Lubiprostone 24 μg BID treatment did not appear to affect opioid use or pain scores; changes from baseline were not significantly different with placebo vs. lubiprostone 24 μg BID at months 1, 2, and 3 for MEDD ( P ≥ 0.435) and for BPI ‐ SF scores for pain interference, pain severity, and worst pain ( P ≥ 0.402). Discussion Lubiprostone 24 μg BID administered for relief of OIC in patients with chronic noncancer pain does not interfere with opioid analgesia.